Your question: Can I Get Only Nose Rasping Done Instead of Full Rhinoplasty?
I like my nose, it's small amp cute but the only problem I have is that from the side I have the biggest bump that is so noticeable. It makes me very insecure and I can't even take pictures of myself except from the front because the bump is that noticeable. I wanted to know if a surgeon can just shave it down instead of breaking my nose? amp how much would it cost?
Dr. Denenberg's answer: Almost certainly need to narrow the bones, but that's not a bad thing
There are a couple reasons not to just shave off the bump. First, if you just shave off the bump, it would leave a flat spot on your nose where the bump was. If the bump is like an Egyptian pyramid, and you take the top off, you are left with a flat plateau. Narrowing the bones makes the bridge of your nose normally narrow again after removing the hump. See my Web reference link for a morph of your nose without the hump, and more explanation of this topic.
There's another, less obvious reason not to just shave it off. When a hump is taken from a nose, it can make the nose look longer, as though the tip drooped down, even if the position of the tip didn't really change. The amount of that effect is different on different people, but the larger the hump, the more likely that we would consider raising the tip a little, not to make a shorty nose, or to change the character of your nose, but just so that the nose doesn't look longer to you after surgery. I made some morphs of that, too. nbsp
Finally, in an operation that takes me about three hours, narrowing the nasal bones takes about three minutes, and it doesn't noticeably increase the swelling or bruising, so it's really a small issue.< p>
From Steven M. Denenberg, M.D.
I made two modifications to your profile. Here is the original:
(Click on the photo above to see rhinoplasty patients of mine.)
In the changed versions, the first one shows only taking down the hump. The second one shows the hump removal, but also a small elevation and narrowing of the tip:
Here is an animation of the first change, just the hump:
And here is an animation of the second change:
Now here are links to the two-page explanation of why we almost always have to narrow the nasal bones when a hump is taken down. These two pages don't have any gross pictures taken during surgery. If you don't want to see gross pictures, just look at these two pages!
First page of explanation
Second page of explanation
Let me know what you think of these modifications.
If you have any questions about this, or if you want me to evaluate any other photos of yours, feel free to email me:
Click here to see most of the morphs that Dr. Denenberg prepared for other RealSelf participants!
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Click here for Dr. Denenberg's profile, and more before and after photos, on RealSelf.com
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Plain talk about picking a plastic surgeon for your first-time or revision rhinoplasty.
I do lots and lots of revision rhinoplasties, and I'll try to give you some advice here, to maximize the chances that you'll be happy after surgery, and to minimize the chances you'll need a revision.
Important!! How to tell whether your consultation was acceptable:
Photos. If a surgeon doesn't show you before and after photographs, scratch him off of your list. Period. No exceptions. Deal-breaker.
You pick a surgeon primarily from his before and after photos. Diplomas, board certifications, hospital affiliations, academic appointment, and even reputation tell you nothing: a surgeon is never tested for his skill, his artistic eye, the quality of his outcomes, or even whether he cares that his patients are happy.
You must see photos of other patients who had some features similar to your nose. For example, if your nose has a wide and drooping tip, don't accept profile-only photos of patients who had a hump carved down. You can't see the width of the tip on a profile photo.
Revision nose operations are much more difficult than first-time operations, so if you are consulting a surgeon about a revision operation, you must see photos of his revision patients.
If you see the surgeon's photos, but you don't love them, scratch him off your list. You want to use a surgeon whose work you like. Don't assume that he'll do great on you when he didn't do great on the other people.
Communication. If the doctor treats you disrespectfully, scratch him off your list. If he won't patiently listen to what you want for your nose, same thing. How will he know how to make you happy if he won't hear what you want for your nose?
If he conducts the consultation from behind his desk and doesn't examine your nose, deal-breaker. If it's the nurse and not the surgeon who conducts the consultation, run away fastest. All due respect to the nurse, she doesn't know what's possible and what isn't. If the plan is to see the surgeon for the first time on the morning of surgery, deal-breaker. For sure.
Computer morphing. If the surgeon doesn't do computer morphing of your nose, scratch him off your list. The morphing is crucial, so the surgeon can prove to you that he understands exactly what your goals are. Also, if the surgeon recommends some changes that you hadn't thought of, you need to see the morphs, so you can see whether you like those changes.
Your intuition. If your gut tells you "no," don't use the surgeon. Don't ever use a surgeon only because you know him, or your kids know him, or he lives on your street, or your primary care doctor referred you to him, or he did your breasts, or your tonsils, or your wisdom teeth, or you saw his advertisement, or his awards.
I hear these stories all the time from my revision rhinoplasty patients. You must do your own evaluation of any surgeon you visit. And by "evaluation," again, we're talking mostly about seeing his photos and seeing how well he communicates with you. Don't bother checking the surgeon's licensure and board certification and hospital affiliations and all that; it'll just distract you from what's important.
Conclusion. The fact is, the great majority of plastic surgeons who perform rhinoplasty shouldn't be doing the operation. It's an incredibly difficult procedure, technically demanding, requiring experience, skill, judgment, an artistic eye, an exceptional level of communication and thoughtfulness, and a rare level of empathy and caring for the patient. No hospital board protects you by judging the quality of a surgeon's rhinoplasties and prohibiting him from operating if he's terrible. It's the wild, wild west out there, folks.
More plain talk: should you let your primary surgeon perform your revision?
Rhinoplasty is by far the most difficult of the facial plastic surgery operations. And revision rhinoplasty is ten times more difficult than a first-time operation.
First, you need to consider whether things didn't turn out great on your first operation because of some unusual circumstance with the surgery or the healing, or whether things went wrong because your doctor was not expert in rhinoplasty in the first place.
Evaluate your surgeon again. Read the section above, on how to evaluate a surgeon for a rhinoplasty. If you saw lots of before and after photos of your surgeon's other patients who got excellent results, in noses at least somewhat similar to yours, then your surgeon probably knows what he is doing, and you can consider letting him perform your revision. Even the very best surgeon has the occasional disappointing result.
However, if, on looking back, you decide that you did not do excellent research on your original surgeon -- perhaps you relied on a referral, or on his board certification, without being able to see his photos -- then you probably should not have him perform the revision. If he couldn't get you close to your goal the first time because of a lack of skill, he will have no chance at all on the second try, and then you'll be in the tough position of looking for a third operation.
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